Smoking can have severe negative impacts on older people, as it exacerbates age-related health issues and is linked to a risk of cognitive decline, which lowers the overall quality of life. This article will explore smoking and its negative impact on older adult individuals.
Increases Health Risks :
Cardiovascular Disease: Smoking accelerates age-related cardiovascular decline and increases the risk of heart disease in older adults. For example, Liu and colleagues conducted a cross-sectional analysis in 2023 to investigate the association between heart disease incidence and smoking status among older adults. The researchers found that current or former smoking was largely associated with heart disease incidence, especially in females and those over 80 years old.
Respiratory Diseases: Older adult smokers are at a higher risk of developing respiratory conditions. For example, a systematic review and meta-analysis by Ramirez and Mackey in 2020 found that severe COVID-19 outcomes were associated with current and former smoking. The study also found that Patients with severe outcomes were older and a larger percentage were males compared with the non-severe outcomes.
Cancer Risk: Smoking is a leading risk factor for lung cancer and also a risk factor for cancers of the mouth, throat, oesophagus, bladder, and colorectal cancer. For instance, research conducted by Chen and colleagues in 2021 found that current smokers had a 48% higher risk of developing colorectal cancer compared to those who had never smoked. According to the World Health Organisation, colorectal cancer predominantly affects older individuals, with the majority of cases occurring in people aged 50 and above.
Surgical Procedure Complications: Older adult smokers are at higher risk of surgical complications. For example, Haeuser and colleagues looked at data from the American College of Surgeons’ National Surgical Quality Improvement Program, covering the years 2011 to 2017. They focused on patients who had radical cystectomy and divided them into two groups: smokers and non-smokers. The researcher concluded that the effect of smoking is stronger with increasing age; the difference concerning complications for smokers versus nonsmokers was found to increase substantially, wherein older smokers are at an especially high risk of complications.
Cognitive Decline: Smoking is linked to a risk of developing cognitive impairment, including dementia, in older adults. For example, a meta-analysis conducted by Anstey and colleagues in 2007 examined the relationship between smoking with dementia, and cognitive decline. Studies included a total of 26,374 participants followed for dementia for 2-30 years and 17,023 participants followed up for 2-7 years to assess cognitive decline. The authors concluded that elderly smokers face a higher risk of developing dementia and experiencing cognitive decline. Similarly, In 2020, The Lancet Commission released a significant report led by 28 worldwide dementia experts. The report identified 12 specific factors that could potentially increase the risk of developing dementia and smoking is one of the factors among them.
Conclusion : Tobacco use can significantly harm older adults, as it exacerbates health problems associated with ageing and increases the likelihood of cognitive decline, negatively impacting overall quality of life. While young adults also face serious health risks from smoking, older individuals are particularly affected due to existing vulnerabilities. Therefore, raising awareness about smoking cessation and its importance at any age is essential for improving health outcomes among the elderly. Understanding these risks can help inform public health initiatives and individual choices, paving the way for healthier, smoke-free futures for older adults.
It is important to understand that smoking carries significant health risks for individuals of all ages. While the article focuses on the impacts of smoking on older adults, the harmful effects of tobacco use are equally relevant to younger individuals.
References :
Anstey, K. J., von Sanden, C., Salim, A., & O’Kearney, R. (2007). Smoking as a Risk Factor for Dementia and Cognitive Decline: A Meta-Analysis of Prospective Studies. American Journal of Epidemiology, 166(4), 367–378. https://doi.org/10.1093/aje/kwm116
Chen, X., Jansen, L., Guo, F., Hoffmeister, M., Chang-Claude, J., & Brenner, H. (2021). Smoking, Genetic Predisposition, and Colorectal Cancer Risk. Clinical and Translational Gastroenterology, 12(3), e00317. https://doi.org/10.14309/ctg.0000000000000317
Haeuser, L., Marchese, M., Schrag, D., Trinh, Q., Chang, S. L., Kibel, A. S., Gore, J. L., Noldus, J., & Mossanen, M. (2021). The impact of smoking on radical cystectomy complications increases in elderly patients. Cancer, 127(9), 1387–1394. https://doi.org/10.1002/cncr.33308
Liu, M., Zheng, M., & He, S. (2023). Association between tobacco smoking and heart disease in older adults: a cross-sectional study based on the Chinese Longitudinal Healthy Longevity Survey. Annals of Translational Medicine, 11(2), 63–63. https://doi.org/10.21037/atm-22-6344
Livingston, G., Huntley, J., Sommerlad, A., Ames, D., Ballard, C., Banerjee, S., Brayne, C., Burns, A., Cohen-Mansfield, J., Cooper, C., Costafreda, S. G., Dias, A., Fox, N., Gitlin, L. N., Howard, R., Kales, H. C., Kivimäki, M., Larson, E. B., Ogunniyi, A., … Mukadam, N. (2020). Dementia prevention, intervention, and care: 2020 report of the Lancet Commission. The Lancet, 396(10248), 413–446. https://doi.org/10.1016/S0140-6736(20)30367-6
Sanchez-Ramirez, D. C., & Mackey, D. (2020). Underlying respiratory diseases, specifically COPD, and smoking are associated with severe COVID-19 outcomes: A systematic review and meta-analysis. Respiratory Medicine, 171, 106096. https://doi.org/10.1016/j.rmed.2020.106096
World Health Organisation. (2023, July 11). Colorectal Cancer. https://www.who.int/news-room/fact-sheets/detail/colorectal-cancer#:~:text=Key%20facts%201%20Colorectal%20cancer%20is%20the%20third,in%20people%20aged%205
© 2025 Dr Mukta Bhattarai Pandey (MD, PGDip Public Health, MRCP(UK), MRes)